Visit-to-visit systolic blood pressure variability, blood pressure treatment intensity, and cognitive decline.
Y, Q., Z, S., X, J., HS, M., & W, Z. (2026). Visit-to-visit systolic blood pressure variability, blood pressure treatment intensity, and cognitive decline.. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.71726
Y Q, Z S, X J, HS M, W Z. Visit-to-visit systolic blood pressure variability, blood pressure treatment intensity, and cognitive decline.. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2026; doi: 10.1002/alz.71726
Y Q, Z S, X J, et al. Visit-to-visit systolic blood pressure variability, blood pressure treatment intensity, and cognitive decline.[J]. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2026. DOI: 10.1002/alz.71726.
@article{y2026,
author = {Qiao Y and Sun Z and Ji X and Markus HS and Zhao W},
title = {Visit-to-visit systolic blood pressure variability, blood pressure treatment intensity, and cognitive decline.},
journal = {Alzheimer's & dementia : the journal of the Alzheimer's Association},
year = {2026},
doi = {10.1002/alz.71726},
note = {PMID: 42535681},
}
TY - JOUR AU - Qiao Y AU - Sun Z AU - Ji X AU - Markus HS AU - Zhao W TI - Visit-to-visit systolic blood pressure variability, blood pressure treatment intensity, and cognitive decline. T2 - Alzheimer's & dementia : the journal of the Alzheimer's Association PY - 2026 DO - 10.1002/alz.71726 AN - PMID:42535681 ER -
INTRODUCTION: Visit-to-visit blood pressure variability (BPV) may be associated with cognitive decline beyond mean blood pressure (BP), but its relevance across treatment contexts remains uncertain. METHODS: We pooled individual-participant data from Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) and Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension (SPRINT-MIND) (n = 11,104). Participants had baseline and follow-up cognitive testing and ≥3 BP measurements from 3 months onwards. The primary exposure was systolic BP variation independent of the mean (SBP-VIM). The primary outcome was annualized change in standardized Digit Symbol Substitution or Coding Test Z-scores. RESULTS: Each 10% increment in SBP-VIM was independently associated with faster annual cognitive decline (β = -0.008 per year; 95% confidence interval [CI]: -0.014 to -0.003) after adjustment including mean SBP. Associations were observed in the intensive but not standard BP treatment arms of both trials, although the pooled interaction was not statistically significant (p = 0.054). DISCUSSION: Higher systolic BPV was associated with accelerated cognitive decline independently of mean BP. The exploratory treatment-context pattern warrants prospective confirmation.